Poor health and isolation can increase suicide risk, experts say

Eastman Kodak founder George Eastman had accomplished much by the age of 77, having revolutionized photography and invented motion-picture film.

One day, he gathered together a group of friends to discuss how he planned to divide up his estate. After the meeting, he excused himself briefly and wrote them a note: “My work is done. Why wait?”

He then shot himself in the heart.

But before we conclude that Eastman was making a sober, well-considered decision to end his days, Kimberly Van Orden, says, consider this: “If you look a little bit closer at George Eastman’s life, we learn that he suffered severe back pain, functional impairment in terms of mobility, had restricted social interactions and likely experienced depression… Suicide is not an expected response to the challenges of aging.”

More Common Than We Think

Van Orden, an Assistant Professor in the Department of Psychiatry at the University of Rochester School of Medicine, took part in a webinar last month on older-adult suicide prevention.

Many associate suicide with young people, like troubled teens or twentysomethings who never quite got their lives off the ground.

In 2013, people ages 45 to 64 had the highest suicide rate, according to figures from the U.S. Centers for Disease Control.

— Kimberly Van Orden, University of Rochester

In fact, it is much more common among older adults. In 2013, for example, people ages 45 to 64 had the highest suicide rate, according to figures from the U.S. Centers for Disease Control. Those 85 and older had the second-highest. (2013 was the last year for which figures are available.) Those at greatest risk? Older white men.

Other factors make suicide attempts more likely to be fatal among older people, Van Orden says.

“Older adults tend to die on their first attempt,” she says. Their frailty often makes them less likely to survive; their isolation makes them less likely to be rescued and “they tend to be more planful and determined in their suicidal behavior.”

Sounding the Alarm

The incidence of older adult suicide has not gone unnoticed by mental health professionals such as Van Orden. Yet they want to raise awareness of the problem among caregivers, family, friends and others who may be able to intervene.

When an older adult has one or more of the following risk factors, his or her loved ones should be especially cognizant of the danger of suicide, Van Orden says:

Depression

Prior suicide attempts

Presence of other medical conditions

Physical pain

Social dependency or isolation

Family discord or loss

Inflexible or rigid personality

Access to lethal means

One of the most important issues to confront is depression, she said. Health care providers should do routine screenings and, if depression is identified, get it treated.

“We know that depression treatment is effective,” at least in reducing thoughts of suicide and likely in reducing suicide itself, Van Orden says.

Acute Risk – The Most Dangerous Time

Warning signs of “acute risk” of suicide, Van Orden says, include:

Threatening to hurt or kill herself or talking of wanting to kill herself

Looking for ways to commit suicide by getting access to pills or weapons, for example

Talking or writing about death or suicide when such actions are not typical

Toward Prevention

Fortunately, there are some “protective factors” that can reduce the risk of suicide, says Rosalyn Blogier, Public Health Adviser with the Substance Abuse and Mental Health Services Administration. Blogier also took part in last month’s webinar, which was sponsored by the National Council on Aging. The protective factors include:

Assessment and care for physical and mental health issues

Social connectedness

Sense of purpose or meaning

Resilience during transitions

Those who work with older adults, including activity directors at senior living centers, have tried to educate residents by offering classes, but the tone of the approach made a difference, says Christine Miara of the Suicide Prevention Resource Center, who also joined the webinar. Stigma around mental health issues remains a very real problem.

“They found out that if they called it [the class] ‘Depression Awareness’ or ‘Reducing Suicide,’ they didn’t get many people to come, but when they gave it a title like, ‘Building Resilience’ or ‘Awakening to Joy’ or ‘No Regrets,’ the participation was much better,” she says.

If you or someone you know is in danger of taking their life, call the National Suicide Prevention Lifeline: 1-800-273-TALK.